Stoelting's Anesthesia and Co-Existing Disease

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001 - Inside front cover
Inside front cover
002 - Front matter
Front matter
Stoelting’s anesthesia and co-existing disease
003 - Copyright
Copyright
004 - Preface
Preface
005 - Contributors
Contributors
006 - Contents
Contents
007 - 1 - Sleep-related breathing disorder
1 Sleep-related breathing disorder
Obstructive sleep apnea (osa)
Adult osa
Apnea
Hypopnea
Respiratory effort–related arousals
Diagnosing osa in adults
Levels of sleep apnea testing
Pathogenesis of osa
Cardiovascular consequences
Neurocognitive consequences
Metabolic consequences
Mortality and economic consequences
Treatment of adult osa
Pap therapy for osa
Oral appliance therapy for osa
Other device therapy for osa
Airway surgical therapy for osa
Bariatric surgery for osa
Adjunct medical therapy for osa
Pediatric osa
Surgical therapy for osa in children
Pap therapy for osa in children
Adjunct medical therapy for osa in children
Central sleep apnea syndromes
Csa with cheyne-stokes breathing
Csa due to a medical disorder without cheyne-stokes breathing
Csa due to high-altitude periodic breathing
Csa due to a medication or substance
Primary csa
Primary csa of infancy
Treatment-emergent csa
Sleep-related hypoventilation disorders
Obesity hypoventilation syndrome (ohs)
Congenital central alveolar hypoventilation syndrome
Late-onset central hypoventilation syndrome with hypothalamic dysfunction (lo-chs/hd)
Idiopathic central alveolar hypoventilation (icah)
Srhv due to a medication or substance
Srhv due to a medical disorder
Sleep-related hypoxemia disorder
Isolated symptoms and normal variants
Snoring
Catathrenia
Effect of sleep on control of breathing
Control of upper airway patency
Effect of sleep on control of upper airway patency
Perioperative considerations in patients with srbd
Practice guidelines for perioperative management of patients with osa
Key points
Resources
008 - 2 - Anesthetic considerations for obstructive lung disease
2 Anesthetic considerations for obstructive lung disease
Acute upper respiratory tract infection
Signs and symptoms
Diagnosis
Management of anesthesia
Asthma
Signs and symptoms
Diagnosis
Pulmonary function testing
Arterial blood gas analysis
Chest radiography and electrocardiography
Treatment
Acute severe asthma
Management of anesthesia
Chronic obstructive pulmonary disease
Signs and symptoms
Diagnosis
Pulmonary function tests
Chest radiography
Computed tomography
Physiologic testing
Blood testing
Treatment
Lung volume reduction surgery
Management of anesthesia
Risk reduction strategies
Preoperative
Smoking cessation.
Effects of smoking cessation.
Intermediate to long-term effects.
Nutritional status.
Preoperative incentive muscle training.
Intraoperative
Regional anesthesia.
General anesthesia.
Postoperative
Lung expansion maneuvers.
Miscellaneous respiratory disorders
Bronchiectasis
Pathophysiology
Diagnosis
Treatment
Management of anesthesia
Cystic fibrosis
Pathophysiology
Diagnosis
Treatment
Clearance of airway secretions.
Bronchodilator therapy.
Reduction in viscoelasticity of sputum.
Antibiotic therapy.
Management of anesthesia
Primary ciliary dyskinesia
Bronchiolitis obliterans
Central airway obstruction
Diagnosis
Management of anesthesia
Key points
Resources
009 - 3 - Restrictive respiratory diseases and lung transplantation
3 Restrictive respiratory diseases and lung transplantation
Acute intrinsic restrictive lung disease (alveolar and interstitial pulmonary edema)
Pulmonary edema
Cardiogenic pulmonary edema
Negative pressure pulmonary edema
Neurogenic pulmonary edema
Reexpansion pulmonary edema
Drug-induced pulmonary edema
High-altitude pulmonary edema (hape)
Management of anesthesia in patients with pulmonary edema
Chemical pneumonitis
E-cigarette (or vaping) product use–associated lung injury (evali)
Covid-19 induced restrictive lung disease
Acute respiratory failure
Overview
Mechanical support for ventilation
Volume-cycled ventilation
A/c ventilation.
Simv.
Pressure-cycled ventilation
Management of patients receiving mechanical support for ventilation
Sedation.
Muscle relaxants.
Complications of mechanical ventilation
Infection.
Barotrauma.
Atelectasis.
Monitoring of treatment
Mixed venous partial pressure of oxygen
Arterial ph
Intrapulmonary shunt
Weaning from the ventilator
Tracheal extubation
Oxygen supplementation
Acute respiratory distress syndrome
Diagnosis
Clinical management
Chronic intrinsic restrictive lung disease (interstitial lung disease)
Sarcoidosis
Hypersensitivity pneumonitis (extrinsic allergic alveolitis)
Pulmonary langerhans cell histiocytosis
Pulmonary alveolar proteinosis (pap)
Lymphangioleiomyomatosis
Aging-related restrictive physiology
Management of anesthesia in patients with chronic interstitial lung disease
Chronic extrinsic restrictive lung disease
Thoracic extrapulmonary causes
Extrathoracic causes
Anesthetic management of patients with restrictive lung disease
Diagnostic procedures in patients with lung disease
Lung transplantation
Overview
Management of anesthesia for primary lung transplantation surgery
Management of anesthesia for patients with prior lung transplantation
Physiologic effects of lung transplantation
Key points
Resources
010 - 4 - Critical illness
4 Critical illness
Pathophysiology of the critically ill patient undergoing surgery
Shock: Disordered perfusion
Hypodynamic shock
Hypovolemic shock.
Cardiogenic shock.
Obstructive shock.
Hyperdynamic shock
Septic shock.
Traumatic shock.
Inflammation: Sepsis and the systemic response to trauma
Commonalities of systemic inflammation
Primary goals: Surviving sepsis
General resuscitative measures.
Diagnosis of septic source.
Empirical antibiotic therapy and infection source control.
Fluid resuscitation.
Vasopressor and inotropic medications.
Steroid management.
Hemoglobin target.
Ventilator measures for sepsis-induced acute respiratory distress syndrome.
General critical care management.
A genomic and molecular perspective
The systemic inflammatory response.
Compensatory antiinflammatory response syndrome (cars).
Persistent inflammation, immunosuppression, and catabolism syndrome (pics).
Hemorrhage: The exsanguinating patient
Classification of hemorrhage
Coagulopathy associated with massive hemorrhage and injury
Damage control resuscitation
Overview and general principles.
Limitation of crystalloid use.
Optimal transfusion practice.
Role of procoagulants in the exsanguinating patient
Clotting factors.
Antifibrinolytic agents.
The anticoagulated patient
Platelet dysfunction and thrombocytopenia.
Acute cardiopulmonary instability
Hemodynamic compromise and circulatory collapse
Cardiac etiologies.
Peripheral etiologies.
Acute exacerbation of respiratory failure
Anatomic mechanical etiologies.
Airway circuit mechanical etiologies.
Primary pulmonary etiologies.
Metabolic derangements
Malnutrition
Overfeeding.
Refeeding syndrome.
Hyperglycemia.
Paradigm shifts.
Sick euthyroid syndrome
Low t3 state.
Low t4 state.
Recovery state.
Treatment.
Utility of thyroid function tests in the critically ill patient.
Relative adrenal insufficiency
Acute renal dysfunction
Rifle criteria.
Akin criteria.
Kdigo criteria.
Cirrhosis
Fulminant hepatic failure
Neurologic disorders
Pain, agitation, and delirium
Pain and analgesia.
Agitation and sedation.
Delirium.
Metabolic encephalopathy
Critical illness polyneuropathy
Acute quadriplegic myopathy
Prolonged effects of neuromuscular blockade
General principles of perioperative management in the critically ill patient
Intravenous fluid management
Parenteral solutions
Maintenance fluid therapy
Resuscitative fluid therapy: Crystalloid versus colloid
Interruption of enteral nutrition preoperatively
Administration of blood products
Emergency transfusion
Reconstitution of prbcs
Mitigation of surgical site infections
Risk factors
Preventive measures
General principles of prophylactic perioperative antibiotic administration
Ongoing antimicrobial management of established infections in the or
Venous thromboembolism prophylaxis
Critically ill nonsurgical patients
Critically ill surgical patients
Nonorthopedic surgical patients.
Orthopedic surgical patients.
Glycemic management
Perioperative impact of diabetes mellitus
Perioperative and intraoperative glycemic control regimens
Steroid management
Indications for administration of stress steroid dosing
Risks associated with stress steroid dosing.
Thermal regulation
Hypothermia
Hyperthermia
Malignant hyperthermia.
Special scenarios in the management of the critically ill surgical patient
Transporting the critically ill patient to and from the operating room
General principles
Maintenance of therapies
Contraindications to transport
Specific operations in critically ill patients
Abdominal compartment syndrome
Definitions.
Significance: Progressive organ failure.
Treatment.
Damage control in the trauma patient
The initial operation: A band-aid for anatomy to facilitate repair of physiology.
The sicu resuscitation: Abrogation of the lethal triad.
The definitive operation: Restoration of anatomy.
After damage control: Subsequent operative interventions
Common operations to facilitate management of the critically ill patient
Tracheostomy.
Enteral feeding access.
Acute management of the critically ill burn patient
Key points
Resources
012 - 6 - Valvular heart disease
011 - 5 - Ischemic heart disease
5 Ischemic heart disease
Stable angina pectoris
Diagnosis
Electrocardiography
Nuclear cardiology techniques
Echocardiography
Stress cardiac MRI
Electron beam CT
CT angiography
Coronary angiography
Treatment
Treatment of associated diseases
Reduction of risk factors and lifestyle modification
Medical treatment of myocardial ischemia
Revascularization
Acute coronary syndrome
St-segment elevation myocardial infarction
Pathophysiology
Diagnosis
Laboratory studies.
Imaging studies.
Treatment
Reperfusion therapy.
Percutaneous coronary intervention.
Coronary artery bypass graft surgery.
Adjunctive medical therapy
Antithrombotic agents.
β blockers.
Inhibition of the renin-angiotensin-aldosterone system.
Other agents.
Non–st-segment elevation acs (ua/nstemi)
Diagnosis
Treatment
Complications of acute myocardial infarction
Postinfarction ischemia
Cardiac dysrhythmias
Pericarditis
Mitral regurgitation
Ventricular septal rupture
Myocardial dysfunction
Cardiogenic shock
Myocardial rupture
Right ventricular infarction
Mural thrombus and stroke
Perioperative implications of percutaneous coronary intervention
Percutaneous coronary intervention and thrombosis
Surgery and risk of stent thrombosis
Surgery and bare-metal stents
Surgery and drug-eluting stents
Risk of bleeding related to antiplatelet drugs
Bleeding versus stent thrombosis in the perioperative period
Perioperative management of patients with stents
Pci-to-surgery interval
Continuation of dual antiplatelet therapy
Perioperative monitoring strategies
Anesthetic technique
Immediate availability of an interventional cardiologist
Perioperative myocardial infarction
Pathophysiology
Diagnosis
Preoperative assessment of patients with known or suspected ischemic heart disease
History
Physical examination
Specialized preoperative testing
Exercise electrocardiography
Stress echocardiography and stress nuclear imaging
CT and MRI
Biomarker measurement
Management of anesthesia in patients with known or suspected ischemic heart disease undergoing noncardiac surgery
Risk stratification
Management after risk stratification
Coronary artery bypass grafting
Percutaneous coronary intervention
Pharmacologic management
Intraoperative management
Monitoring
Intraoperative management of myocardial ischemia
Postoperative management
Cardiac transplantation
Management of anesthesia
Postoperative complications
Anesthetic considerations in heart transplant recipients
Response to drugs
Preoperative evaluation
Management of anesthesia
Key points
Resources
6 Valvular heart disease
Introduction
Stenotic VS regurgitant lesions
Structural and functional response of left ventricle to pressure and/or volume overload
Evaluation of valvular heart disease
Aortic stenosis
Etiology
Pathophysiology
Clinical manifestations and diagnosis
Timing and type of intervention
Intraoperative management
Aortic regurgitation
Etiology
Pathophysiology
Clinical manifestations and diagnosis
Timing and type of interventions
Intraoperative management
Mitral stenosis
Etiology
Pathophysiology
Clinical manifestations and diagnosis
Timing and type of intervention
Intraoperative management
Mitral regurgitation
Etiology
Pathophysiology
Clinical manifestations and diagnosis
Timing and type of interventions
Intraoperative management
Tricuspid stenosis
Tricuspid regurgitation
Etiology
Pathophysiology
Clinical manifestations and diagnosis
Timing and type of intervention
Intraoperative management
Pulmonic stenosis
Pulmonic regurgitation
Prevention of infective endocarditis
Prosthetic heart valves
Types of prosthetic heart valves
Complications associated with prosthetic heart valves
Assessment of prosthetic heart valves
Antithrombotic therapy for prosthetic heart valves
Key points
Resources
013 - 7 - Congenital heart disease
7 Congenital heart disease
Congenital heart lesions
Acyanotic congenital heart disease
Shunting lesions
Atrial septal defect
Signs and symptoms.
Management of anesthesia.
Ventricular septal defect
Signs and symptoms.
Management of anesthesia.
Patent ductus arteriosus (pda)
Signs and symptoms.
Management of anesthesia.
Obstructive lesions
Aortic stenosis.
Signs and symptoms.
Management of anesthesia.
Pulmonic stenosis.
Signs and symptoms.
Management of anesthesia.
Coarctation of the aorta.
Signs and symptoms.
Management of anesthesia.
Ebstein anomaly.
Signs and symptoms.
Management of anesthesia.
Cyanotic congenital heart disease
Tetralogy of fallot
Signs and symptoms.
Management of anesthesia.
Preoperative preparation.
Induction and maintenance of anesthesia.
Eisenmenger syndrome
Signs and symptoms.
Management of anesthesia.
Tricuspid atresia
Signs and symptoms.
Management of anesthesia.
Transposition of the great arteries
Signs and symptoms.
Management of anesthesia.
Truncus arteriosus
Signs and symptoms.
Management of anesthesia.
Partial anomalous pulmonary venous return
Total anomalous pulmonary venous return
Signs and symptoms.
Management of anesthesia.
Hypoplastic left heart syndrome
Signs and symptoms.
Management of anesthesia.
Mechanical obstruction of the trachea
Double aortic arch
Aberrant left pulmonary artery
Noncardiac surgery in the adult patient with congenital heart disease
Preoperative evaluation
Premedication
Endocarditis prophylaxis
Vascular access
Dysrhythmia
Pulmonary hypertension
Heart failure
Bleeding diathesis
Intraoperative management
Postoperative management
Echocardiography in congenital heart disease
Important management strategies for adults with congenital heart disease
Infective endocarditis prophylaxis
Management of pulmonary hypertension
Balancing pulmonary and vascular resistance (qp:qs)
Modifying pulmonary and systemic vascular resistance
Onset of intravenous and inhaled agents
Left-to-right shunts
Right-to-left shunts
The univentricular heart during different stages of repair
Surgical management
Key points
Resources
014 - 8 - Abnormalities of cardiac conduction and cardiac rhythm
8 Abnormalities of cardiac conduction and cardiac rhythm
Introduction
Conduction system of the heart overview
Physiologic actions represented in the ECG
Cardiac conduction disturbances
First-degree atrioventricular heart block
Second-degree atrioventricular heart block
Third-degree atrioventricular heart block
Intraventricular conduction disturbances
Right bundle branch block
Left bundle branch block
Cardiac resynchronization therapy
Anesthesia for insertion of ICDs
Surgery in patients with cardiac implantable electronic devices
Preoperative evaluation
Cardiac dysrhythmia overview
Mechanisms of tachydysrhythmias
Increased automaticity
Reentry pathways
Triggering by afterdepolarizations
Supraventricular dysrhythmias
Sinus tachycardia
Premature atrial beats
Paroxysmal supraventricular tachycardia
Wolff-parkinson-white syndrome
Multifocal atrial tachycardia
Atrial fibrillation
Atrial flutter
Ventricular dysrhythmias
Ventricular ectopy (premature ventricular beats)
Ventricular tachycardia
Ventricular fibrillation
Mechanisms of bradydysrhythmias
Sinus bradycardia
Junctional rhythm
Treatment of cardiac dysrhythmias
Antidysrhythmic drugs
Adenosine
Atropine
Amiodarone
β-adrenergic blockers
Calcium channel blockers
Digoxin
Vasopressin
Dopamine
Epinephrine
Isoproterenol
Lidocaine
Magnesium
Procainamide
Sotalol
Twenty percent lipid emulsion
Transcutaneous pacing
Electrical cardioversion
Defibrillation
Radiofrequency catheter ablation
Cardiac implanted electronic devices
Permanently implanted cardiac pacemakers
Pacing modes
Asynchronous pacing.
Single-chamber pacing.
Dual-chamber pacing.
Ddd pacing.
Ddi pacing.
Rate-adaptive pacemakers
Anesthesia for cardiac pacemaker insertion
Key points
Resources
015 - 9 - Systemic and pulmonary arterial hypertension
9 Systemic and pulmonary arterial hypertension
Systemic hypertension
Public health implications
Pathophysiology
Current treatment of hypertension
Lifestyle modification
Pharmacologic therapy
Treatment of secondary hypertension
Perioperative implications of hypertension
Preoperative evaluation
Intraoperative considerations
Induction of anesthesia and monitoring
Maintenance of anesthesia
Hypertensive crises
Acute postoperative hypertension
Pulmonary arterial hypertension
Definitions and classification
Definition
Hemodynamic classification
Who clinical classification
Pathophysiology and pharmacologic treatment
Prostanoids
Endothelin receptor antagonists
Nitric oxide/guanylate cyclase
Perioperative considerations
Preoperative evaluation
Assessing risk factors
Outcome studies
Perioperative physiology
Right ventricular afterload.
Right ventricular inotropy.
Myocardial supply and demand.
Procedural considerations
Orthopedics
Laparoscopy
Thoracic surgery
Key points
Resources
016 - 10 - Heart failure and cardiomyopathies
10 Heart failure and cardiomyopathies
Heart failure
Definition
Epidemiology and etiology
Pathophysiology of heart failure
Left ventricular diastolic dysfunction
Left ventricular systolic dysfunction
Ventricular-arterial stiffening and abnormal lv-arterial coupling
Left atrial systolic and diastolic dysfunction
Acute versus chronic heart failure
Diagnosis of heart failure
Signs and symptoms
Medical imaging
Chest radiography
Echocardiography
Electrocardiography
Laboratory values
Classification of heart failure
Management of heart failure
Medical management
Chronic heart failure
Diuretics.
β blockers.
Inhibitors of the renin-angiotensin-aldosterone system.
Other medications.
Lifestyle modifications and control of comorbidities.
Acute heart failure
Diuretics.
Vasodilators.
Vasopressin receptor antagonists.
Inotropic support.
Calcium sensitizers.
Exogenous b-type natriuretic peptide.
Surgical management
Chronic heart failure
Revascularization therapy.
Cardiac resynchronization therapy.
Implantable hemodynamic monitors.
Implantable cardioverter-defibrillators.
Left ventricular assist devices.
Acute heart failure
Intraaortic balloon pump.
Impella.
Peripheral vad/ecmo.
Central vad/ecmo.
Biventricular assist device (bivad).
Anesthetic management
Preoperative evaluation
Intraoperative management
Monitoring
Choice of anesthetic
Fluid replacement
Anesthetic considerations for heart transplant patients
Anesthetic considerations for patients with implantable nonpulsatile vads
Postoperative period
Cardiomyopathies
Hypertrophic cardiomyopathy
Signs and symptoms
Diagnosis
Treatment
Medical therapy.
Surgical therapy.
Prognosis
Management of anesthesia
Preoperative evaluation and management.
Intraoperative management.
Parturient patients.
Postoperative management.
Dilated cardiomyopathy
Signs and symptoms
Diagnosis
Treatment
Prognosis
Management of anesthesia
Stress cardiomyopathy
Diagnosis, treatment, and prognosis
Peripartum cardiomyopathy
Signs and symptoms
Diagnosis
Treatment
Prognosis
Management of anesthesia
Secondary cardiomyopathies with restrictive physiology
Signs and symptoms
Diagnosis
Treatment and prognosis
Management of anesthesia
Cor pulmonale
Pathophysiology
Signs and symptoms
Diagnosis
Treatment
Prognosis
Management of anesthesia
Key points
Resources
017 - 11 - Pericardial disease and cardiac trauma
11 Pericardial disease and cardiac trauma
Introduction
Pericardial structure and function
Congenital abnormalities
Pericarditis
Diagnosis
Treatment
Postcardiac injury syndromes
Pericardial effusion and tamponade
Etiology
Pathophysiology
Diagnosis
Echocardiographic imaging in pericardial effusion and tamponade
Hemopericardium
Treatment
Management of anesthesia
Constrictive pericarditis
Pathophysiology
Diagnosis
Treatment
Management of anesthesia
Cardiac trauma
Blunt cardiac injuries
Diagnosis
Treatment
Commotio cordis
Penetrating cardiac trauma
Aortic injuries
Diagnosis
Treatment
Key points
Resources
018 - 12 - Vascular disease
12 Vascular disease
Diseases of the thoracic and abdominal aorta
Aneurysms and dissections of the thoracic and abdominal aorta
Incidence
Etiology
Classification
Signs and symptoms
Diagnosis
Medical management of aortic aneurysms
Preoperative evaluation
Indications for surgery
Rupture of abdominal aortic aneurysm
Aortic dissections
Type a dissection.
Ascending aorta.
Aortic arch.
Type b dissection
Descending thoracic aorta.
Unique risks of surgery
Surgical approach.
Anterior spinal artery syndrome.
Spinal cord blood supply.
Risk factors.
Hemodynamic responses to aortic cross clamping.
Hemodynamic responses to aortic unclamping.
Management of anesthesia
Monitoring blood pressure
Monitoring neurologic function
Monitoring cardiac function
Monitoring intravascular volume and renal function
Induction and maintenance of anesthesia
Postoperative management
Endovascular aortic aneurysm repair
Complications
Anesthetic management
Postoperative management
Reboa (resuscitative endovascular balloon occlusion of the aorta)
Carotid artery disease and stroke
Epidemiology and risk factors
Cerebrovascular anatomy
Diagnostic tests
Treatment of stroke
Carotid endarterectomy
Preoperative evaluation
Management of anesthesia
Postoperative management and complications
Endovascular treatment of carotid disease
Peripheral arterial disease
Chronic arterial insufficiency
Risk factors
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Postoperative management
Subclavian steal syndrome
Coronary-subclavian steal syndrome
Acute arterial occlusion
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Raynaud phenomenon
Diagnosis
Treatment
Management of anesthesia
Peripheral venous disease
Superficial thrombophlebitis and deep vein thrombosis
Prevention of venous thromboembolism
Clinical risk factors.
Regional anesthesia.
Treatment of deep vein thrombosis
Complications of anticoagulation.
Systemic vasculitis
Temporal (giant cell) arteritis
Thromboangiitis obliterans (buerger disease)
Signs and symptoms
Treatment
Management of anesthesia
Polyarteritis nodosa
Lower extremity chronic venous disease
Key points
Resources
019 - 13 - Diseases affecting the brain
13 Diseases affecting the brain
Cerebral physiology
Cerebral blood flow, blood volume, and metabolism
Arterial carbon dioxide partial pressure
Arterial oxygen partial pressure
Cerebral perfusion pressure and cerebral autoregulation
Cerebral venous blood pressure
Anesthetic drugs
Increased intracranial pressure
Methods to decrease intracranial pressure
Specific causes of increased intracranial pressure
Aqueductal stenosis
Benign intracranial hypertension
Normal pressure hydrocephalus
Spontaneous intracranial hypotension
Intracranial tumors
Specific brain tumor classes
Astrocytoma
Oligodendroglioma
Ependymoma
Primitive neuroectodermal tumor
Meningioma
Pituitary tumor
Acoustic neuroma
Central nervous system lymphoma
Metastatic tumor
Management of anesthesia
Preoperative management
Induction of anesthesia
Maintenance of anesthesia
Fluid therapy
Monitoring
Postoperative management
Sitting position and venous air embolism
Disorders related to vegetative brain function
Coma
Management of anesthesia
Brain death and organ donation
Management of anesthesia
Cerebrovascular disease
Cerebrovascular anatomy
Acute ischemic stroke
Management of acute ischemic stroke
Management of anesthesia for ischemic stroke revascularization
Perioperative and periprocedural stroke
Acute hemorrhagic stroke
Intraparenchymal hemorrhage
Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage and intracranial aneurysms
Management of anesthesia.
Arteriovenous malformation
Venous angioma
Cavernous angioma
Capillary telangiectasia
Arteriovenous fistula
Management of anesthesia
Moyamoya disease
Management of anesthesia
Traumatic brain injury
Management of anesthesia
Congenital anomalies of the brain
Chiari malformation
Tuberous sclerosis
Von hippel–lindau disease
Neurofibromatosis
Degenerative diseases of the brain
Alzheimer disease
Parkinson disease
Huntington disease
Torticollis
Transmissible spongiform encephalopathies
Multiple sclerosis
Postpolio sequelae
Seizure disorders
Status epilepticus
Perioperative neurocognitive disorders
Neuroocular disorders
Leber optic atrophy
Retinitis pigmentosa
Kearns-sayer syndrome
Ischemic optic neuropathy
Anterior ischemic optic neuropathy
Posterior ischemic optic neuropathy
Cortical blindness
Retinal artery occlusion
Ophthalmic venous obstruction
Key points
Resources
020 - 14 - Disorders of the spine and spinal cord
14 Disorders of the spine and spinal cord
Anatomy of the vertebral column and spinal cord
Spinal cord injury
Acute spinal cord injury
Management of anesthesia
Chronic spinal cord injury
Management of anesthesia
Autonomic hyperreflexia
Elective spine surgery
Indications for elective spine surgery
Disk disease
Spondylosis and spondylolisthesis
Scoliosis
Spinal cord tumors
Management of anesthesia
Congenital anomalies and degenerative diseases of the vertebral column
Spina bifida occulta
Meningocele and myelomeningocele
Tethered spinal cord syndrome
Syringomyelia
Amyotrophic lateral sclerosis
Friedreich ataxia
Key points
Resources
021 - 15 - Diseases of the autonomic and peripheral nervous systems
15 Diseases of the autonomic and peripheral nervous systems
Introduction
Overview of the autonomic nervous system
Autonomic nervous system disorders
Multiple system atrophy
Management of anesthesia
Postural orthostatic tachycardia syndrome
Management of anesthesia
Paraganglioma
Management of anesthesia
Carotid sinus hypersensitivity
Management of anesthesia
Hyperhidrosis
Management of anesthesia
Paroxysmal sympathetic hyperactivity
Management of anesthesia
Familial dysautonomia
Management of anesthesia
Diseases of the peripheral nervous system
Idiopathic facial paralysis (bell palsy)
Trigeminal neuralgia (tic douloureux)
Glossopharyngeal neuralgia
Management of anesthesia
Charcot-marie-tooth disease
Management of anesthesia
Brachial plexus neuropathy
Guillain-barré syndrome (acute idiopathic polyneuritis)
Management of anesthesia
Entrapment neuropathies
Carpal tunnel syndrome
Ulnar neuropathy
Meralgia paresthetica
Complex regional pain syndrome
Management of anesthesia
Diseases associated with peripheral neuropathies
Diabetes mellitus
Alcohol abuse
Vitamin b12 deficiency
Uremia
Cancer
Collagen vascular diseases
Sarcoidosis
Acquired immunodeficiency syndrome–associated neuropathy
Perioperative peripheral neuropathies
Key points
Resources
022 - 16 - Diseases of the liver and biliary tract
16 Diseases of the liver and biliary tract
Epidemiology
Functions of the liver
Liver anatomy
Assessment of liver function
Diseases of the biliary tract
Biliary tract anatomy
Cholelithiasis
Choledocholithiasis
Hyperbilirubinemia
Gilbert syndrome
Crigler-najjar syndrome
Benign postoperative intrahepatic cholestasis
Hepatitis
Viral hepatitis
Covid-19
Alcohol-associated liver disease
Nonalcoholic fatty liver disease
Autoimmune hepatitis
Drug-induced liver injury
Inborn errors of metabolism
Wilson disease
α1-antitrypsin deficiency
Hemochromatosis
Primary biliary cholangitis
Primary sclerosing cholangitis
Cardiac causes of liver disease
Acute liver failure (formerly fulminant hepatic failure)
Cirrhosis
Portal hypertension
Ascites and spontaneous bacterial peritonitis
Varices
Hepatic encephalopathy
Hepatorenal syndrome
Hepatopulmonary syndrome
Portopulmonary hypertension
Anesthesia for patients with liver disease
Abnormal liver chemistry in the surgical patient
Procedures and operations for liver disease
Transjugular intrahepatic portosystemic shunt
Partial hepatectomy
Liver transplantation
Key points
Resources
023 - 17 - Diseases of the gastrointestinal system
17 Diseases of the gastrointestinal system
Procedures to evaluate and treat diseases of the gastrointestinal system
Upper gastrointestinal endoscopy
Colonoscopy
Other diagnostic tools
Diseases of the esophagus
Symptoms of esophageal disease
Esophageal motility disorders
The chicago classification
Achalasia
Treatment.
Anesthetic concerns.
Distal esophageal spasm
Esophageal structural disorders
Esophageal diverticula
Hiatal hernia
Esophageal tumors
Esophagectomy.
Morbidity and mortality.
Anesthetic implications.
Gastroesophageal reflux disease
Pathophysiology of gerd
Complications of gerd
Treatment
Perioperative management and anesthetic considerations
Peptic ulcer disease
Helicobacter pylori
Complications
Bleeding
Perforation
Obstruction
Gastric ulcer
Stress gastritis
Treatment
Antacids
H2-receptor antagonists
Proton pump inhibitors
Prostaglandin analogues
Cytoprotective agents
Miscellaneous drugs
Treatment of helicobacter pylori infection
Surgical treatment
Zollinger-ellison syndrome
Pathophysiology
Treatment
Management of anesthesia
Postgastrectomy syndromes
Dumping
Alkaline reflux gastritis
Inflammatory bowel disease
Ulcerative colitis
Complications
Crohn disease
Treatment of inflammatory bowel disease
Surgical treatment
Medical treatment
Carcinoid tumors
Carcinoid tumors without carcinoid syndrome
Carcinoid tumors with systemic symptoms due to secreted products
Carcinoid syndrome
Treatment
Management of anesthesia
Acute pancreatitis
Pathogenesis
Complications
Treatment
Chronic pancreatitis
Gastrointestinal bleeding
Upper gastrointestinal tract bleeding
Lower gastrointestinal tract bleeding
Adynamic ileus
Key points
Resources
024 - 18 - Inborn errors of metabolism
18 Inborn errors of metabolism
Porphyria
Classification
Acute porphyria
Acute intermittent porphyria
Variegate porphyria
Hereditary coproporphyria
Ala dehydratase porphyria
Nonacute porphyrias
Porphyria cutanea tarda
Congenital erythropoietic protoporphyria
Erythropoietic protoporphyria
X-linked protoporphyria
Acute attacks of porphyria
Triggering drugs
Management of anesthesia
Regional anesthesia
General anesthesia
Treatment of a porphyric crisis
Gout
Treatment.
Management of anesthesia.
Lesch-nyhan syndrome
Disorders of carbohydrate metabolism
Hemochromatosis
Wilson disease
Key points
Resources
025 - 19 - Nutritional diseases_ Obesity and malnutrition
19 Nutritional diseases: Obesity and malnutrition
Keywords:
Obesity
Definition
Epidemiology
Pathophysiology
Fat storage
Environmental factors
Psychological and socioeconomic factors
Diseases associated with obesity
Metabolic syndrome.
Glucose intolerance and t2dm.
Cardiovascular disorders
Systemic hypertension.
Coronary artery disease.
Heart failure.
Respiratory disorders
Lung volumes.
Gas exchange and work of breathing.
Lung compliance and airway resistance.
Obstructive sleep apnea.
Obesity hypoventilation syndrome.
Gastrointestinal disorders
Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis.
Gallbladder disease.
Gastric emptying and gastroesophageal reflux disease.
Cancer
Thromboembolic disorders
Musculoskeletal disorders
Nervous system
Treatment of obesity
Lifestyle therapy
Medical therapy
Surgical therapy
Weight-loss surgery.
Types of bariatric surgery
Restrictive bariatric procedures.
Malabsorptive bariatric procedures.
Combined bariatric procedures.
Surgical complications.
Protein-calorie malnutrition.
Fat malabsorption.
Consideration of bariatric surgery in pediatric and adolescent patients.
Endoscopic and nonsurgical procedures.
Management of anesthesia in patients with obesity
Preoperative evaluation
History.
Physical examination and airway examination.
Preoperative diagnostic tests.
Home medications.
Intraoperative management
Positioning.
Laparoscopic surgery.
Choice of anesthesia.
Regional and neuraxial anesthesia.
General anesthesia.
Airway management.
Management of ventilation.
Induction and maintenance of anesthesia
Monitoring.
Fluid management.
Emergence.
Postoperative management
Postoperative analgesia.
Respiratory and cardiovascular monitoring and management.
Discharge to an unmonitored setting.
Postoperative complications.
The outpatient with obesity
Malnutrition and micronutrient abnormalities
Malnutrition
Screening and diagnosis
Malnourished obesity, a double burden
Micronutrient deficiency
Enteral nutrition
Parenteral nutrition
Vitamin deficiencies
Key points
Resources
026 - 20 - Fluid, electrolyte, and acid-base disorders
20 Fluid, electrolyte, and acid-base disorders
Abnormalities of water, osmolality, and electrolytes
Water and osmolal homeostasis
Disorders of sodium
Hyponatremia
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Transurethral resection of the prostate (turp) syndrome
Hypernatremia
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Disorders of potassium
Hypokalemia
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Hyperkalemia
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Disorders of calcium
Hypocalcemia
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Hypercalcemia
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Disorders of magnesium
Hypomagnesemia
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Hypermagnesemia
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Acid-base disorders
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Metabolic alkalosis
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Key points
Resources
027 - 21 - Renal disease
21 Renal disease
Introduction
Clinical assessment of renal function
Glomerular filtration rate
Serum creatinine and creatinine clearance
Blood urea nitrogen
Urine concentrating ability
Proteinuria
Fractional excretion of sodium
Urinalysis
Acute kidney injury
Diagnosis of acute kidney injury
Etiology of acute kidney injury
Prerenal disease
Intrinsic renal disease
Postrenal disease
Risk factors for development of acute kidney injury
Complications associated with acute kidney injury
Treatment of acute kidney injury
Prognosis for patients with acute kidney injury
Drug dosing in patients with acute kidney injury
Anesthetic management of patients with acute kidney injury
Chronic kidney disease
Diagnosis
Progression of chronic kidney disease
Adaptation to chronic kidney disease
Complications of chronic kidney disease affect multiple organ system
Cardiovascular
Anemia
Uremic bleeding
Renal osteodystrophy
Neurologic
Immunologic
Prevention and treatment of complications of chronic kidney disease
Cardiovascular
Anemia
Nutrition
Renal osteodystrophy
Uremic bleeding
Renal replacement therapy
Hemodialysis
Peritoneal dialysis
Drug clearance in patients undergoing dialysis
Vascular access
Complications associated with hemodialysis
Intradialytic complications.
Malnutrition and metabolic
Infection
Anesthetic management of patients with chronic kidney disease
Preoperative evaluation
Monitoring
Induction of anesthesia
Maintenance of anesthesia
Fluid management and urine output
Anesthesia for vascular access
Patient positioning
Perioperative hemodialysis
Postoperative management
Renal transplantation
Management of anesthesia
Postoperative complications
Anesthetic considerations in renal transplant recipients presenting for surgery
Conditions affecting renal function
Glomerular diseases
Nephrotic syndrome
Glomerulonephritis
Goodpasture syndrome
Interstitial nephritis
Hereditary nephritis
Polycystic kidney disease
Bartter and gitelman syndromes
Renal tubular acidosis
Fanconi syndrome
Nephrolithiasis
Uric acid nephropathy
Renal hypertension
Hepatorenal syndrome
Benign prostatic hyperplasia
Turp syndrome
Key points
Resources
028 - 22 - Endocrine disease
22 Endocrine disease
Diabetes mellitus
Signs and symptoms
Type 1 diabetes
Type 2 diabetes
Diagnosis
Treatment
Oral antidiabetic drugs
Insulin
Complications
Diabetic ketoacidosis
Hyperglycemic hyperosmolar syndrome
Microvascular complications
Nephropathy
Peripheral neuropathy
Retinopathy
Autonomic neuropathy
Macrovascular complications
Management of anesthesia
Preoperative evaluation
Intraoperative management
Postoperative care
Insulinoma
Thyroid disease
Diagnosis
Hyperthyroidism
Signs and symptoms
Treatment
Management of anesthesia
Thyroid storm
Hypothyroidism
Signs and symptoms
Treatment
Management of anesthesia
Myxedema coma
Goiter and thyroid tumors
Complications of thyroid surgery
Adrenal gland dysfunction
Pheochromocytoma
Signs and symptoms
Diagnosis
Management of anesthesia
Preoperative management
Intraoperative management
Postoperative management
Hypercortisolism (cushing syndrome)
Diagnosis
Treatment
Management of anesthesia
Primary hyperaldosteronism (conn syndrome)
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Hypoaldosteronism
Adrenal insufficiency
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
ICU management
Parathyroid gland dysfunction
Hyperparathyroidism
Primary hyperparathyroidism
Diagnosis
Signs and symptoms
Treatment
Management of anesthesia
Secondary hyperparathyroidism
Hypoparathyroidism
Diagnosis
Signs and symptoms
Treatment
Management of anesthesia
Pituitary gland dysfunction
Acromegaly
Signs and symptoms
Treatment
Management of anesthesia
Diabetes insipidus
Inappropriate secretion of antidiuretic hormone
Key points
Resources
029 - 23 - Hematologic disorders
23 Hematologic disorders
Physiology of anemia
The transfusion trigger
Management of anesthesia: General concepts for anemia
Evaluation and classification of anemia
Microcytic anemias
Iron-deficiency anemia
Diagnosis.
Treatment.
Thalassemia
Thalassemia minor.
Thalassemia intermedia.
Thalassemia major.
Management of anesthesia.
Normocytic anemias
Hemolytic anemias
Disorders of red cell structure.
Hereditary spherocytosis.
Management of anesthesia.
Hereditary elliptocytosis.
Acanthocytosis.
Paroxysmal nocturnal hemoglobinuria.
Treatment of pnh.
Management of anesthesia.
Disorders of red cell metabolism.
Embden-meyerhof pathway.
Phosphogluconate pathway.
Glucose-6-phosphate dehydrogenase deficiency.
Pyruvate kinase deficiency.
Methemoglobin reductase pathway.
Luebering-rapoport pathway.
Disorders of hemoglobin.
Sickle s hemoglobin.
Management of anesthesia.
Sickle c hemoglobin.
Management of anesthesia.
Sickle hemoglobin–β thalassemia.
Unstable hemoglobins.
Management of anesthesia.
Autoimmune hemolytic anemias.
Anemia of chronic disease
Treatment.
Anemia of chronic kidney disease
Aplastic anemia
Management of anesthesia.
Macrocytic/megaloblastic anemias
Folate and vitamin b12 deficiency anemia
Other hemoglobin-related disorders
Hemoglobins with increased oxygen affinity
Management of anesthesia
Hemoglobins with decreased oxygen affinity
Methemoglobinemia
Management of anesthesia.
Polycythemia
Physiology of polycythemia
Polycythemia vera
Management of anesthesia
Secondary polycythemia due to hypoxia
Secondary polycythemia due to increased erythropoietin production
Management of anesthesia in secondary polycythemia
Disorders of hemostasis
Normal hemostasis
Cascade coagulation model
New coagulation model
Hemostatic disorders affecting coagulation factors of the initiation phase
Factor VII deficiency
Management of anesthesia.
Congenital deficiencies in factor X, factor V, and prothrombin (factor II)
Hemostatic disorders affecting coagulation factors of the propagation phase
Congenital factor VIII deficiency: Hemophilia a
Management of anesthesia.
Congenital factor IX deficiency: Hemophilia b
Management of anesthesia.
Acquired factor VIII or IX inhibitors
Management of anesthesia.
Factor XI deficiency
Management of anesthesia.
Congenital abnormalities in fibrinogen
Hypofibrinogenemia and afibrinogenemia.
Dysfibrinogenemia.
Management of anesthesia.
Factor XIII deficiency
Management of anesthesia.
Arterial coagulation
Disorders affecting platelet number
General concepts for treating thrombocytopenia
Congenital disorders resulting in platelet production defects
Acquired disorders resulting in platelet production defects
Management of anesthesia
Nonimmune platelet destruction disorders
Thrombotic thrombocytopenic purpura
Drug-induced tma
Hemolytic uremic syndrome
Hellp syndrome
Management of anesthesia in nonimmune platelet destruction disorders
Autoimmune platelet destruction disorders
Thrombocytopenic purpura in adults
Posttransfusion purpura.
Drug-induced autoimmune thrombocytopenia.
Heparin-induced thrombocytopenia.
Management of anesthesia.
Idiopathic thrombocytopenic purpura.
Management of anesthesia.
Qualitative platelet disorders
Congenital disorders affecting platelet function
Von willebrand disease.
Type 1 disease.
Type 2 disease.
Type 3 disease.
Management of anesthesia.
Acquired abnormalities of platelet function
Myeloproliferative disease.
Dysproteinemia.
Uremia.
Liver disease.
Drug-induced platelet dysfunction.
Management of anesthesia in patients with qualitative platelet disorders
Hypercoagulable disorders
Heritable causes of hypercoagulability
Thrombophilia due to decreased antithrombotic proteins
Hereditary antithrombin deficiency.
Hereditary protein c and protein s deficiency.
Thrombophilia due to increased prothrombotic proteins
Factor V leiden.
Prothrombin gene mutation.
Acquired causes of hypercoagulability
Myeloproliferative disorders
Malignancies
Pregnancy and oral contraceptive use
Nephrotic syndrome
Antiphospholipid antibodies
Management of anesthesia in venous hypercoagulable disorders
Anesthetic considerations in patients receiving long-term anticoagulant therapy
Key points
Resources
030 - 24 - Skin and collagen disorders
24 Skin and collagen disorders
Skin diseases
Acanthosis nigricans
Atopic dermatitis
Epidermolysis bullosa
Pemphigus
Mastocytosis
Urticaria
Erythema multiforme
Scleroderma
Management of anesthesia
Disorders of elastin and collagen
Pseudoxanthoma elasticum
Management of anesthesia
Ehlers-danlos syndrome
Management of anesthesia
Marfan syndrome
Management of anesthesia
Disorders of muscles and neuromuscular junction
Inflammatory myopathies
Polymyositis and dermatomyositis
Management of anesthesia.
Muscular dystrophy
Pseudohypertrophic muscular dystrophy (duchenne muscular dystrophy)
Management of anesthesia.
Becker muscular dystrophy
Limb-girdle muscular dystrophy
Facioscapulohumeral muscular dystrophy
Oculopharyngeal dystrophy
Emery-dreifuss muscular dystrophy
Myotonic dystrophy
Myotonia dystrophica.
Management of anesthesia.
Inherited myopathies
Nemaline rod myopathy
Management of anesthesia.
Myotonia congenita
Paramyotonia congenita
Periodic paralysis
Management of anesthesia.
Hypokalemic periodic paralysis.
Hyperkalemic periodic paralysis.
Central core disease
Multicore myopathy
Management of anesthesia.
Centronuclear myopathy
Management of anesthesia.
Mitochondrial myopathies
Management of anesthesia
Other myopathies
Alcoholic myopathy
Floppy infant syndrome
Management of anesthesia.
Diseases of the neuromuscular junction
Myasthenia gravis
Signs and symptoms.
Treatment.
Management of anesthesia.
Myasthenic syndrome
Management of anesthesia.
Malignant hyperthermia susceptibility
Skeletal diseases
Osteoarthritis
Anesthetic considerations
Kyphoscoliosis
Management of anesthesia
Back pain
Acute low back pain
Lumbar spinal stenosis
Rheumatoid arthritis
Management of anesthesia
Systemic lupus erythematosus
Management of anesthesia
Spondyloarthropathies
Ankylosing spondylitis
Management of anesthesia.
Reactive arthritis
Chronic juvenile polyarthropathy
Enteropathic arthritis
Paget disease
Dwarfism
Achondroplasia
Management of anesthesia.
Russell-silver syndrome
Management of anesthesia.
Tumoral calcinosis
Disorders of the shoulder
Management of anesthesia
Tracheomegaly
Prader-willi syndrome
Management of anesthesia
Prune-belly syndrome
Meige syndrome
Spasmodic dysphonia
Management of anesthesia
Chondrodysplasia calcificans
Erythromelalgia
Farber lipogranulomatosis
Klippel-feil syndrome
Osteogenesis imperfecta
Management of anesthesia
Fibrodysplasia ossificans
Deformities of the sternum
Macroglossia
Key points
Resources
031 - 25 - Infectious diseases
25 Infectious diseases
Infection prevention overview
Antibiotic resistance
Surgical site infections
Risk factors for surgical site infections
Signs and symptoms
Diagnosis
Management of anesthesia
Preoperative.
Intraoperative
Prophylactic antibiotics.
Physical and physiologic preventive measures.
Oxygen.
Analgesia.
Carbon dioxide.
Glucose.
Wound-probing protocols.
Bloodborne infections
Bloodstream infections
Signs and symptoms
Diagnosis
Treatment
Management of anesthesia
Preoperative.
Intraoperative.
Postoperative.
Sepsis
Signs and symptoms
Diagnosis
Treatment
Prognosis
Management of anesthesia
Preoperative.
Intraoperative.
Postoperative.
Gastrointestinal infections
Clostridium difficile infection
Signs and symptoms
Diagnosis
Treatment
Prognosis
Management of anesthesia
Preoperative.
Intraoperative.
Postoperative.
Cutaneous infections
Necrotizing soft tissue infection
Signs and symptoms
Diagnosis
Treatment
Prognosis
Management of anesthesia
Preoperative.
Intraoperative.
Postoperative.
Tetanus
Signs and symptoms
Treatment
Management of anesthesia
Respiratory infections
Pneumonia
Community-acquired pneumonia
Aspiration pneumonia
Postoperative pneumonia
Lung abscess
Diagnosis
Treatment
Prognosis
Management of anesthesia
Ventilator-associated pneumonia
Diagnosis
Treatment and prognosis
Management of anesthesia
Severe acute respiratory syndrome (sars) and influenza
Signs and symptoms
Diagnosis
Treatment
Prognosis
Management of anesthesia
Preoperative.
Intraoperative.
Postoperative.
Tuberculosis
Diagnosis
Treatment
Management of anesthesia
Infectious diseases in solid organ transplant recipients
Infectious disease occurrence
Management of anesthesia
Preoperative
Intraoperative
Postoperative
HIV infection and AIDS
Signs and symptoms
Diagnosis
HIV infection clinical continuum
Cardiac manifestations
Central and peripheral nervous system manifestations
Pulmonary manifestations
Endocrine manifestations
Hematologic manifestations
Renal manifestations
Treatment
Prognosis
Management of anesthesia
Preoperative
Intraoperative
Postoperative
Emerging and unusual infectious disease threats
Ebola virus disease
Infection control
Treatment
Mycobacterium chimaera
Background
Identification of patients
Prevention
Treatment
Coronavirus (covid-19)
Background
Transmission
Clinical picture
Severe infection
Testing and identification
Treatment
Impact on perioperative sector
Scheduling covid-positive patients for surgery
Key points
Resources
World wide web links
032 - 26 - Diseases related to immune system dysfunction
26 Diseases related to immune system dysfunction
Introduction
Inadequate innate immunity
Neutropenia
Neutropenia in pediatric patients
Neutropenia in adults
Abnormalities of phagocytosis
Management of patients with neutropenia or abnormalities of phagocytosis
Deficiencies in components of the complement system
Hyposplenism
Excessive innate immunity
Neutrophilia
Monocytosis
Asthma
Misdirected innate immunity
Angioedema
Management of anesthesia
Inadequate adaptive immunity
Defects of antibody production
Defects of t lymphocytes
Combined immune system defects
Excessive adaptive immunity
Allergic reactions
Anaphylaxis
Diagnosis
Treatment
Drug allergy
Background
Allergic drug reactions during the perioperative period
Antibiotics.
Sugammadex.
Induction drugs.
Local anesthetics.
Opioids.
Nsaids and aspirin.
Volatile anesthetics.
Radiocontrast media.
Latex.
Protamine.
Blood, blood products, and synthetic volume expanders.
Other agents.
Eosinophilia
Misdirected adaptive immunity
Autoimmune disorders
Anesthesia and immunocompetence
Transfusion-related immunomodulation
Resistance to infection
Resistance to cancer
Key points
Resources
033 - 27 - Cancer
27 Cancer
Introduction
Mechanism
Diagnosis
Treatment
Traditional chemotherapy
Targeted chemotherapy
Radiation
Side effects of cancer treatment
Cardiovascular system
Respiratory system
Renal system
Hepatic system
Airway and oral cavity
Gastrointestinal system
Endocrine system
Hematologic system
Nervous system
Tumor lysis syndrome
Cancer immunology
Diagnosis
Immunomodulators
Cancer vaccines
Paraneoplastic syndromes
Fever and cachexia
Neurologic abnormalities
Endocrine abnormalities
Syndrome of inappropriate antidiuretic hormone
Hypercalcemia
Cushing syndrome
Hypoglycemia
Renal abnormalities
Dermatologic and rheumatologic abnormalities
Hematologic abnormalities
Local effects of cancer and metastases
Superior vena cava syndrome/superior mediastinal syndrome
Spinal cord compression
Increased intracranial pressure
Cancer pain
Pathophysiology
Drug therapy
Radiation therapy
Neuraxial analgesia
Neurolytic procedures
Preoperative evaluation and management
Anesthesia technique and tumor progression
Common cancers encountered in clinical practice
Lung cancer
Etiology
Signs and symptoms
Histologic subtypes
Diagnosis
Treatment
Management of anesthesia
Colorectal cancer
Etiology
Diagnosis
Signs and symptoms
Treatment
Management of anesthesia
Prostate cancer
Diagnosis
Treatment
Breast cancer
Risk factors
Screening
Prognosis
Treatment
Systemic treatment
Tamoxifen.
Chemotherapy.
Supportive treatment
Management of anesthesia
Less common cancers encountered in clinical practice
Cardiac tumors
Head and neck cancers
Thyroid cancer
Esophageal cancer
Gastric cancer
Hepatocellular carcinoma
Pancreatic cancer
Renal cell carcinoma
Bladder cancer
Testicular cancer
Cervical and uterine cancer
Ovarian cancer
Skin cancer
Bone cancer
Multiple myeloma
Osteosarcoma
Ewing sarcoma
Chondrosarcoma
Lymphomas and leukemias
Hodgkin lymphoma
Non-hodgkin lymphoma
Leukemia
Acute lymphoblastic leukemia
Chronic lymphocytic leukemia
Acute myeloid leukemia
Chronic myeloid leukemia
Hematopoietic stem cell transplantation
Anesthesia for bone marrow transplantation
Complications of bone marrow transplantation
Graft-versus-host disease.
Graft rejection.
Pulmonary complications.
Sinusoidal obstruction syndrome.
Key points
Resources
034 - 28 - Chronic pain
28 Chronic pain
Ketamine infusion
Lidocaine infusion
Patients with chronic opioid use
Patients on buprenorphine therapy
Phantom limb pain
Cancer
Fibromyalgia
Complex regional pain syndrome
Patients with severe obesity
Intrathecal drug delivery systems
Neuromodulation devices
Pregnancy
Key points
Resources
035 - 29 - Psychiatric disease, substance use disorders, and drug overdose
29 Psychiatric disease, substance use disorders, and drug overdose
Mood disorders
Depression
Diagnosis
Treatment
Ssris.
Serotonin syndrome.
Monoamine oxidase inhibitors.
Management of anesthesia.
Postoperative care.
Nonpharmacologic treatments of depression.
Management of anesthesia.
Bipolar disorder
Treatment
Lithium.
Management of anesthesia.
Schizophrenia
Treatment
Management of anesthesia
Neuroleptic malignant syndrome
Anxiety disorders
Eating disorders
Anorexia nervosa
Signs and symptoms
Treatment
Management of anesthesia
Bulimia nervosa
Signs and symptoms
Treatment
Binge-eating disorder
Substance use and substance use disorders
Screening for unhealthy substance use
Diagnosis of substance use disorder
Perioperative management of patients with substance use disorders
Alcohol
Overdose
Acute alcohol withdrawal syndrome
Alcohol use disorder treatment
Anesthesia considerations
Cocaine
Overdose
Treatment
Management of anesthesia
Opioids
Overdose
Withdrawal syndrome
Treatment
Management of anesthesia
Barbiturates
Overdose
Withdrawal syndrome
Benzodiazepines
Amphetamines
Overdose
Withdrawal syndrome
Management of anesthesia
Designer/club drugs
Hallucinogens
Overdose
Management of anesthesia
Cannabis
Management of anesthesia
Substance abuse as an occupational hazard in anesthesiology
Why anesthesiologists?
Demographic characteristics of anesthesiologists with substance use disorders
Most frequently abused drugs
Methods of obtaining drugs for misuse
Signs and symptoms of addiction
Associated risks of physician addiction
Physician.
Process for dealing with suspected substance use disorder
Reporting and intervention
Treatment
Acetaminophen overdose
Poisoning
Organophosphate poisoning
Carbon monoxide poisoning
Pathophysiology
Signs and symptoms
Diagnosis
Treatment
Key points
Resources
036 - 30 - Diseases of aging
30 Diseases of aging
Introduction
Biology of aging
Physiologic effects of aging
Central nervous system
Cardiovascular system
Respiratory system
Renal system, fluids, and electrolytes
Gastrointestinal system
Immune system
Endocrine function
Sarcopenia and body composition
Frailty
Geriatric syndromes
Dementia
Falls and balance disorders
Pharmacokinetic and pharmacodynamic changes with aging
Management of anesthesia
Inhalational anesthetics
Propofol
Etomidate
Thiopental
Midazolam
Opioids
Fentanyl.
Remifentanil.
Meperidine.
Neuromuscular blocking drugs
Perioperative outcomes after cardiac and noncardiac surgery
Perioperative care of elderly patients
Preoperative assessment
Nutrition and anorexia
Functional status
Cognition
Medication review
Goals of care
Preoperative assessment of patients undergoing urgent or emergent surgery
Intraoperative management
Monitoring
Anesthetic management
Fluid therapy/blood transfusion
Postoperative management
Postoperative delirium and cognitive dysfunction
Postoperative pain control
Care of the elderly in the ICU
Key points
Resources
037 - 31 - Pediatric diseases
31 Pediatric diseases
Unique considerations in pediatric patients
Anesthesia-induced developmental neurotoxicity
Anxiety and behavioral health
Anatomy and physiology
Body size and thermoregulation
Airway
Respiratory system
Cardiovascular system
Fluids and renal physiology
Hepatic system
Hematologic system
Pharmacology
Anesthetic requirements
Pharmacokinetics
Pediatric cardiac arrest during anesthesia
Causes of cardiac arrest
Management
The preterm newborn
Definition
Respiratory distress syndrome
Signs and symptoms
Treatment
Management of anesthesia
Bronchopulmonary dysplasia
Signs and symptoms
Treatment
Management of anesthesia
Laryngomalacia and bronchomalacia
Retinopathy of prematurity
Signs and symptoms
Treatment
Management of anesthesia
Apnea of prematurity
Signs and symptoms
Treatment
Postanesthetic apnea
Hypoglycemia
Signs and symptoms
Treatment
Hypocalcemia
Signs and symptoms
Treatment
Surgical diseases of the newborn
Congenital diaphragmatic hernia
Signs and symptoms
Treatment
Management of anesthesia
Postoperative management
Esophageal atresia and tracheoesophageal fistula
Signs and symptoms
Treatment
Management of anesthesia
Omphalocele and gastroschisis
Signs and symptoms
Omphalocele.
Gastroschisis.
Treatment
Management of anesthesia
Colonic and anorectal anomalies
Signs and symptoms
Treatment
Management of anesthesia
Infantile hypertrophic pyloric stenosis
Signs and symptoms
Treatment
Management of anesthesia
Necrotizing enterocolitis
Signs and symptoms
Treatment
Management of anesthesia
Biliary atresia
Signs and symptoms
Treatment
Management of anesthesia
Central nervous system disorders
Cerebral palsy
Signs and symptoms
Management of anesthesia
Hydrocephalus
Signs and symptoms
Treatment
Management of anesthesia
Spina bifida
Signs and symptoms
Treatment
Management of anesthesia
Craniosynostosis
Signs and symptoms
Treatment
Management of anesthesia
Spinal muscular atrophy
Signs and symptoms
Treatment
Management of anesthesia
Craniofacial anomalies
Orofacial clefts
Signs and symptoms
Treatment
Management of anesthesia
Mandibular hypoplasia
Pierre-robin sequence
Hemifacial microsomia
Treacher collins syndrome
Management of anesthesia
Midface hypoplasia
Apert syndrome
Crouzon syndrome
Management of anesthesia
Upper airway disorders
Acute epiglottitis (supraglottitis)
Signs and symptoms
Management of anesthesia
Postintubation laryngeal edema
Signs and symptoms
Management of anesthesia
Subglottic stenosis
Signs and symptoms
Treatment
Management of anesthesia
Foreign body aspiration
Signs and symptoms
Treatment
Management of anesthesia
Laryngeal papillomatosis
Signs and symptoms
Treatment
Management of anesthesia
Adenotonsillar hypertrophy/sleep-disordered breathing
Signs and symptoms
Treatment
Management of anesthesia
Upper respiratory infection
Management of anesthesia
Genitourinary disorders
Vesicoureteral reflux
Treatment
Cryptorchidism
Hypospadias
Management of anesthesia
Orthopedic/musculoskeletal disorders
Clubfoot (talipes equinovarus)
Management of anesthesia
Slipped capital femoral epiphysis
Management of anesthesia
Developmental dysplasia of the hip
Management of anesthesia
Infantile idiopathic scoliosis
Treatment
Management of anesthesia
Childhood malignancies
Acute lymphoblastic leukemia/lymphoblastic lymphoma
Management of anesthesia
Wilms tumor
Management of anesthesia
Neuroblastoma
Management of anesthesia
Ewing sarcoma
Management of anesthesia
Tumors of the central nervous system
Gliomas
Medulloblastoma
Craniopharyngiomas
Management of anesthesia
Retinoblastoma
Management of anesthesia
Down syndrome (trisomy 21)
Malignant hyperthermia
Key points
Resources
038 - 32 - Pregnancy-associated diseases
32 Pregnancy-associated diseases
Physiologic changes associated with pregnancy (table 32.1)
Cardiovascular system
Respiratory system
Hematologic system
Gastrointestinal system
Endocrine system
Other changes
Nonobstetric surgery during pregnancy
Anesthesia in the breastfeeding woman
Obstetric anesthesia care
General principles
Neuraxial anesthesia/analgesia
Hypertensive disorders of pregnancy
Gestational hypertension
Preeclampsia
Pathophysiology
Clinical presentation
Treatment
Labor analgesia
Spinal anesthesia.
General anesthesia.
Eclampsia
Eclampsia: Not an indication for cesarean delivery or any immediate delivery
Heart disease
Risk assessment and classification
Management of anesthesia
Obesity
Epidemiology/outcomes
Management of anesthesia
Preanesthetic.
Neuraxial analgesia.
Cesarean delivery.
Key points
Resources